Tom has severe athetoid cerebral palsy. From the age of two he attended a special school for children with cerebral palsy. Initially he communicated using his eyes to show what he wanted. At 3 years old he got his first chance to use a voice output communication aid (VOCA) operated using a single switch which he pressed with his head. By the time he was 5 he had a more powerful system using a program with 144 pictures. He had to combine these pictures together to say words and phrases. He was also using some naturally spoken language that could be understood by people who knew him well. He had begun to learn to read using symbols. He was not very keen to use his VOCA and found remembering the key picture sequences difficult. He continued to use his head switch to type on the computer and became a very good at reading and spelling. Between the ages of 8 and 12 he became less and less willing to use his VOCA to communicate verbally. He said the 144 pictures meant that scanning took too long and he couldn't remember where to find the words he wanted to use.

At around the age of 13 Tom was offered a chance to try a different VOCA which had 45 locations and used written words instead of pictures. He found this much easier, as well as using it for spoken communication it was linked to his computer so that he could use it to produce written work more quickly. He continued to attend special school until the age of 19 with further changes of VOCA enabling him to use eye gaze, as well as the head switch, to operate the system. He got GCSEs in ICT and maths and went on to attend a local college. The summer after he left school he bought a PCEye which gave him a much quicker and easier way to operate his computer and he is using this to take part in a mainstream college course and is hoping to eventually do a degree.

Tom's VOCA story began when technology choices were quite limited and he has made excellent use of the many improvements and increasing options throughout his school life. He now combines his communication system with his environmental controls so that by using a single switch and eye-gaze, and employing personal assistants he is able to live independently.